Is it a person's "fault" if they're fat? What does that question really mean?

I'm writing in response to various comments in another thread a few days ago where people were getting all steamed up about "fat shaming" and "taking personal responsibility" and the like.

Just to get this out of the way, I'm currently 178 lbs at 6'0", having lost 85 lbs since last April, along with 10" from my waist, taking me down to 30" waist jeans that I had to mail order since 30x34 is a hard size to find locally. (I guess it says something about the average American male that 34x30, not 30x34, is in plentiful supply.) My last physical (when I'd only lost about 50 of the 85 lbs.) showed I was very healthy in terms of cholesterol, blood sugar, and plenty of other measures. (My blood pressure, oddly enough, went up for a while, just crossing into Stage 1 hypertension, but it's back to a healthy value again. I blame the then on-going election! )

I say this not to fish for compliments (well, OK, maybe a little!) but because some people don't seem to take you seriously about diet and exercise unless you're in good shape, even if same information and opinions you might convey are shared by both fit and fat people. I would have said much the same things I'm going to say now back when I was 263 lbs.

Was it my fault I'd gotten so fat? Is it to my credit that I've become fit and trim? Does what applies to me apply very much to anyone else?

I grew up an out-of-shape geek, the kid picked last for teams in high school gym. I didn't get fit until my 30s, I let myself go during my 40s, and in just the past year I've gotten myself back on track at 50. Clearly I can make up my mind to eat better and exercise, and I get good results when I do. Just as clearly, I can also fail when a situation that makes it a lot easier for me to take the time for exercise (a work-at-home job I held for seven years) gets replaced with a less conducive situation (losing 1.5-2 hours a day to commuting, feeling more worn out from working and driving).

I don't think "fault" is always such a clear concept, even though people get very impassioned about what is and isn't a person's fault. It's more useful to consider of how easy or hard some personal choices might be. Does a choice require trivial or heroic effort, or something in between? Can 8 out of 10 people resist an extra cookie in one situation, but change circumstances a bit, and only 3 out of 10 can resist?

As a thought experiment, imagine an overweight prisoner locked in a cell. The only food he can get is what a jailer provides him through a narrow slot. Imagine further than the calories burned by the prisoner are closely monitored -- not just calories burned via exercise and general motion, but calories burned by all metabolic activity.

Human bodies follow the laws of physics. I can guarantee you (minor issues such as water retention aside) that if the jailer puts fewer calories through the slot than the prisoner burns, the prisoner will lose weight over time. He might be very unhappy about it, he might suffer from frequent and distressing hunger pangs, and if the jailer makes poor nutritional choices the prisoner might become ill or malnourished -- but he will lose weight.

I know that the phrase "calories in, calories out" infuriates some people, but when you fully account for every bit of the "in" and the "out" (which can be complicated and nuanced) you can't help but lose weight when your body is burning more calories than it is taking in. The energy your body uses has to come from somewhere, and if that energy is not in your food, your body has to start breaking down fat and/or other body tissues to provide that energy. People who struggle with weight loss, whatever their real you-don't-want-to-blame-them-for-it problems might be, do not have a magical ability to suck energy out of the aether. A "low metabolism" can only go so low if you're still alive.

If you aren't locked in a cell, if you aren't being fed by a calorie-counting jailer, it's a difficult question how much calorie-counting knowledge and discipline (or adherence to good non-calorie-counting habits which yield equivalent results) is a reasonable expectation for any given person, especially when we're not just talking about food calories ("in"), but knowledge of your own metabolism and activity in terms of caloric values ("out").

Some people stay at a healthy weight with little effort at all. They aren't especially disciplined or conscientious, they aren't counting calories, they eat what they want, they don't go out of their way to exercise -- they're just lucky. Others have to work hard at reaching and maintaining a healthy weight, but they succeed. Some work hard and fail. Some, for good or bad reasons, don't make much effort at all.

When you look at the American population as a whole, clearly something is going wrong with our high and growing rates of obesity. A large portion of the population didn't simply transform from good, hard-working responsible people into bad, lazy, irresponsible louts. Many things about our food supply, eating habits, and physical activity have changed. You can, of course, blame the Evil Capitalists and Evil Corporations for that, and they certainly bear some of the blame, but they can't do all that they do without the public cooperating to some extent. They won't sell it if we won't buy it.

It is simultaneously dastardly yet eminently understandable that a snack food maker, given resources like focus groups and food laboratories, will be driven to figure out how to make you want to keep eating their tasty treats until your hand reaches the bottom of the supposedly six-serving bag.

Would you outlaw this kind of irresistibility in food? Would you tax it? Warning-label it? How much responsibility do you place on the consumer to resist temptation and exercise self-control?

Some people say, for example, diet soda makes you gain weight. Let's suppose this is true (might be real cause and effect, might be more a matter of mistaking correlation for causation), and the reason it's true is that diet soda increases your appetite for foods that contain the calories that the soda doesn't contain. If so, you still have to give into those cravings before the unwanted weight gain occurs. If you drink diet soda, feel those cravings, yet still manage to restrict your calorie intake, you will still be able to lose weight. It might be a more stressful, unpleasant task, more prone to eventual failure, but in the bigger picture the diet soda can only be an indirect cause of weight gain. It's an unclear value judgment whether a person's susceptibility to induced cravings and ability to battle those cravings when they occur constitute a blame-worthy failing.

I've been able to change my eating habits and even my food cravings themselves so healthier eating comes more naturally. Can I expect that will work for everyone? No. Do I think people who are eating poorly should at least give it a try? Yes.

I now do lots of exercise, several hours worth every week, cardio and weight training. But I've now got a blissfully short commute to work, and a free gym at the office. I'm quite sympathetic to people not being able to find the time to exercise as much as I do now. On the other hand, I think people should reconsider their priorities if they aren't doing what they can do to make at least some time for some exercise.

There are good medical reasons why the potential for exercise is limited for some people. On the other hand, I've seen people like my own father use every excuse he could for inactivity, not fighting to do as much as was still possible for him to do, until he essentially crippled himself for the last 10-15 years of his life.

I have no clear conclusion to present, just a mixed bag of feelings and a sense of many gray areas. I know that many individual people could improve their health if only they decide to do it. I know that's easier said than done. I know good excuses for poor health exist, I certainly don't want to go as far as the mindless "motivational" rhetoric of people who smugly shout "NO excuses!", but that many of those excuses aren't as good as many people think. I'm pretty sure that most people who claim to "eat like a bird" but can't lose weight are simply in denial about how much they eat and/or suffer badly from "portion distortion". I believe that real metabolic disorders exist, but that they aren't as common as claims to suffer from them are. I believe we've created a food environment that makes it harder to find healthy food, harder to resist overeating, but that with some effort we can all eat better. I believe a lot of improvement in diet can be made without getting fanatical about all-natural, all-organic, non-GMO, gluten-free, etc. -- you shouldn't give up on eating better just because the whole package deal of "clean eating" fanatics seems horribly restrictive and overwhelming (and perhaps, in some areas, absurdly and needlessly puritanical).

1. Read up on adenovirus serotype 36.

Food Nazis who scrutinize every bite an overweight person takes in public are overly puritanical. They're also dead wrong in most cases about how simple overweight is bad for one's health. They've found that older women at the insurance industry's "normal" weight died at a faster rate than did women who were classed as "overweight."

Antifat bigotry is the last acceptable bigotry because the bigots all pretend they're oh, so concerned about a fat person's present and future health. Many fat people can run circles around the thin at the gym and there is no motivation for getting the biggest nutritional bang for the calorie than having a bunch of people looking down their long blue noses at you because you are not thin.

The fact is that human beings come in all shapes, sizes, colors and from all sorts of points of origin and we have to accept them just the way they are because no one is going to change everything about his life just to suit us.

7. Mere "overweight" certainly isn't always a problem

The BMI scale, for one thing, doesn't deal very well with muscle mass. Some people thought I'd already gotten pretty thin when I hit 190, but I wasn't even at the upper edge of "normal" for my height until I reached 185. And even if you don't look thin -- sure, not everyone has to look like a fashion model to be healthy, not by far.

On the other hand, there is plenty of seriously detrimental obesity out there in the world, and it doesn't seem likely that our population is fattening up overall by means of a whole bunch of people changing intrinsic body type or getting "fat, but in a healthy way" all at once.

As for the virus... it would be interesting to know not just the correlation with obesity (which a bit of Googling easily found), but any understanding of how the virus might work -- for instance, does it increase appetite, decrease metabolism, a bit of both, something else?

17. Anti Southern bigotry is remarkably popular on DU

So I would say that anti fat bigotry is not the last acceptable bigotry.

Personally even though I average fifteen miles a day on my bicycle I'm still just under what would be considered obese in terms of weight for my height.

I also found out from one of the Abercrombie and Fitch threads that I'm only about two inches above the average American twenty something male in waist size despite the fact I'm drawing SS and somewhat over average height.

51. She must also breast feed someone,

2. I agree with much of what you say, but my big complaint

is why do people care so much if I'm fat? or you were fat?
And don't say it's bad for insurance rates. That's bullshit, especially in my case since I haven't been to the doctor in years and I'm perfectly healthy.
It's prejudice plain and simple.

The thing is, I don't care what you think.. not you in particular, but the people who fear fat people.

(PS.. I'm not huge fat, just normal fat)

I can predict: "but don't you want to be healthy? or look better?"
I answer: butt out, it's none of your business.

6. our society is very much based on vanity and self righteousness.

Most people don't question whether a skinny person is healthy or not when in fact you can be skinny and unhealthy. Skinny people are pleasant to look at. Our society has deemed that big people are not appealing to look at. It's almost like we have to be punished for forcing others to look at something they would rather not look at. Personally, I think that is why they care if someone is fat or not. So they accuse us of being unhealthy, lazy, and slovenly.

19. yes, it's prejudice pure and simple; and has a class bias as well.

24. I certainly cared by myself that I was fat, and cared for myself.

Part of what kept me fat for so long, I realize in retrospect, was an amazing amount of denial about how much weight I'd gained. I certainly knew I was overweight, but it hadn't fully sunk in that I'd definitely crossed into obesity. It might be fair to say that I "carried it well" for a while, but "carried it well" realistically might cover 20-30 lbs, not all of the 80-plus pounds that I've lost.

I got to the point where my knees were starting to bother me more and more often, where just getting up off the couch sometimes seemed like a bit too much effort, requiring leaning on the arm of the couch to help. I was snoring more, and began to catch myself exhibiting what I think was the start of a problem with sleep apnea. Getting in and out of my car was starting to seem like a bigger deal that it should be. Bending over to tie my shoes became an uncomfortable strain.

It still took my wife's purchase of a new bathroom scale, and seeing 263 come up after having not weighed myself for some time, to finally push me over the edge, to take my then-brewing plan to start eating better and to exercise and actually start it the next day.

To some extent I had feared exercising and losing weight again because I'd suffered badly from clinical depression during the first span in my life, during my 30s, when I'd first become fit and thin. It turns out there is such a thing as "exercise-induced depression", so my fear might have been partly justifiable, but I think it also became a rationalization for me too.

Fortunately this time around I've not experienced any such problems. Either the depression I experienced before was unrelated and coincidental, or something about my new approach to eating and exercise doesn't cause the same problem.

I'll admit there's certainly a component of vanity to my desire for weight loss. Fair or unfair that our social conventions might be, it does feel good to know a lot more people around you think you look good, and plenty even say so. That wouldn't have been enough to make me work as hard as I have to lose weight... but it helps!

3. What gets me

Is people who say, "It's simple. Consume fewer calories than you burn."

The math is easy. The execution isn't. You get hungry. It's misery for hours and hours. I wouldn't tell someone with a horrible headache that "It's simple. It'll go away."

That doesn't mean it's impossible, but it's HARD, and the last thing I need is some pompous ass acting as if I'm morally defective because I'm not thin.

And let's not overlook the fact that the ideal in our society isn't thin, especially for women. The ideal is scrawny. I'm amazed at some of the bodies that are held up to me as beautiful. I want to scream "Eat a sandwich, for the love of God."

BTW, I'm not obese by any means. I was larger, but I've lost 40 pounds. Losing the weight is another JOB on top of everything else I have to do. I have to get up at 4:50 three days a week to exercise, and almost 24/7 I have to put up with hunger. I'm hungry right now, but I don't dare eat something for fear I'll stop losing weight. So, don't tell me it's simple.

22. I'll take your "don't tell me it's simple" as a general comment to the world at large...

...rather than aimed at me specifically, since I don't think I implied simplicity of execution of a weight loss plan anywhere.

If you find yourself hungry all of the time, you might want to experiment with changing what you're eating when you do eat. No guarantees it will help, of course -- I don't want to be one of those annoying people who thinks that whatever worked for me is the magic bullet for everyone, nor do I want to presume that perhaps you haven't tried this already.

While I still have to exercise some will power now and then to resist eating unneeded calories, I've avoided the serious bouts of hunger that I experienced back during the 90s when I followed a low-fat diet. Back then I spent most of a decade being hungry a good bit of the time. This past year, following a different diet, has been MUCH easier on me than what I'd endured before.

For me eating a lot more fresh and bulky vegetables, a bit more fat than I used to consider healthy from my low-fat days, and eating fewer sugary or other high glycemic index foods has really helped make it easier to keep my hunger under control so keeping the calorie count down isn't so big a struggle.

26. Not aimed at you

30. Consuming less than you burn is flat out impossible over the long term

That's because what you burn changes if you eat less. Your metabolism becomes more efficient and you "need" less, and less and less. It would be great if bank accounts worked like that--take out money, and more gets added automatically.

4. A big misconception is that "healthy weight" people are healthy

My husband was 6' and probably about 165 when we got together. He lifted weights and worked out. In fact I would sit in the weight room and moan and groan for him (it annoyed him).

Me? I hover around 200. I used to kid with him, telling him that if he got sick, he'd be gone fairly quickly, while I- with my extra fat would linger a lot longer and have a bigger opportunity to make a lot of people miserable before I died.

Guess which one of has been dead for 10 years? He looked healthy but was actually very sick. While I am a little on the fat side and still have no health issues. So go figure

8. It's certainly a misconception to look at weight alone and go no deeper

In general, however, extra body fat isn't likely to provide useful health benefits, except perhaps some protection in extremes of health where losing weight and needing a larger fat reserve becomes a problem.

Some people smoke all of their long lives, for example, while some non-smokers die young. That doesn't mean smoking is a healthy habit, it just means other factors at times can and do outweigh a single factor like smoking.

9. congratulations on your continuing efforts to stay healthy.

I've been doing well for about two and an half months now. I've even started doing things I never thought I would try to try and battle my sugar addiction. I am trying to buy things unsweetened. I'm eating unsweetened yogurt and driking unsweetened green tea. It took some getting use to let me tell you. I'm also trying to buy dressings and sauces and other condiments that don't have high fructose corn syrup. I'm eating things I know will boost my immune system like green tea, fruits and vegetables, mushrooms(also taking some getting use to), and garlic. I'm still not exercising as much as I should. I did go for a short walk yesterday, but it's not a regular thing. I've lost about 13 lbs, but I am not concentrating on what the scale says. I'm just trying to do things that I know are good for my body.

16. While I certainly eat less sugar than before, I didn't have to go as far as elimination...

...of added sugar, either temporarily or long term. Same with carbs, simple or complex -- I eat fewer carbs, I try to make more of my carbs whole grains, but I'm not afraid of a little white rice or non-whole-grain pasta now and then. I'm less concerned about fat consumption (especially if it's healthy fats like olive oil or nuts) than I was back when I did a low-fat diet in the 90s.

The biggest changes in my eating were learning sensible portion control, not eating desserts and unhealthy snacks nearly as much as I used to, eating far fewer fried foods than I used to, and eating a lot more fresh vegetables. I've gotten to understand which foods keep me feeling satisfied longer vs. the foods that carry a lot of calories but satisfy only briefly, leaving me soon hungry for more.

Exercise has been critical. If I didn't exercise as much as I do, it's possible that I'd have to be stricter about what I eat. Today, for example, I splurged by adding an oatmeal-raisin cookie bar to my lunch, something I guess added an extra 400 calories to my lunch. On the other hand, I'd walked briskly 4.5 miles before going to work, walked 0.75 miles round trip to get to the gym at work from my office, did a half-hour weight training session, and followed that by a fairly intense 30 minutes on an elliptical-like machine called an Arc trainer.

I'd burned around 1400 calories via exercise during the day which, even with that cookie bar, cancelled out all of the calories I'd eaten for lunch and breakfast. When it was time for supper I could eat as much as 2200 calories just to break even with what I need to support my basal metabolic rate.

Not every day do I exercise so intensely, but not everyday do I give into cookie bars either. I'm now exercising 6-7 days a week, typically burning at least 900-1000 calories per day, often as much as 1300-1400, rarely as few as 500-600.

I find myself in the odd predicament that I'm still dropping in weight more than I want to, but I'm finding it hard to convince myself to eat more, which I'll have to do if I want to start building up more muscle. I've got about 20% body fat now, but I'd like to build up more muscle until I get down to at least 17%.

23. I allow myself a day of indulgence every once in a while but if I allow myself lit bits of sugar too

often then I can't control my cravings. It has been a while. I'm thinking about having some yummies this weekend. That is a lot of exercise you do. I have chronic fatigue. Bouts of intense exercise exhaust me and make me have to take a nap. Plus my chronic fatigue triggers my sugar cravings. The green tea helps my chronic fatigue some. I do enjoy taking short walks, and I've been thinking of doing some short hikes as well.

12. Lots of different motivations for eating/excessive caloric intake or inability to lose weight.

1) The main issue I've noticed is over-eating due to Stress/Comfort-seeking - when stressed, many people have an overwhelming craving to eat "baby food" types of food, especially simple starchy/fatty foods, to get through the the mental pressure of their day. The more stress, the more the body and mind want fuel endorphins and hormones - i.e. "to eat" - so much so that the subconscious will play tricks on itself to put more comfort food in the body before the person consciously realizes they've eaten the entire amount of cheesy potato chips, lasagna, or pint of ice-cream that they were going to indulge in "just a few bites" to make it through the work-day.

2)Body thinks it's in starvation mode is another one that dieters especially face. When the "dieter" drastically changes diet or cuts back on his or her food/caloric intake - and adds to that heavy exercise (and/or emotional stress), the body metabolizes calories at a far slower rate and will work even harder to store fat rather than burn it because the dieter is obviously experiencing "famine time". Sticking with a diet when your body thinks it's starving is a constant fight that many people have serious problems dealing with.

3)The six month (or one year, depending on how you estimate and your personal metabolism) rule of thumb concerning the ability to successfully change or develop established habits. It isn't just a mental habit change, it is also a physical issue while the body is re-setting it's hormonal and/or bio-chemical baselines. I've seen it happen over and over - someone goes on a diet regime in June, is doing great through September - and hits the holiday season before the "habit" has really taken hold. Any weakness in willpower (Mom and Dad - "Just a drink won't hurt, just a bite won't hurt...") and you have to go right back to square one.

4) Allergies and access to Food. Food deserts are difficult places to live, and people who have allergies and live in food deserts have an even more difficult time. I know about the food allergies - I'm mildly allergic to corn and vegetable based proteins, as well as pollens and molds. Corn messes up in my GI track, so it doesn't get metabolized well and anything with corn in it (pretty much anything you get in the store or restaurants these days). I don't get "sick", but I never know if I'm going to get constipated, gain weight or lose weight if I eat anything with corn from day to day. Someone like me might keep weight regulated if there's access to a lot of fresh food and free time to cook, but too many other people have to shop at the dollar menu and whatever is in the convenience store/"bargain bin" store, and have minimum to no control over the quality of the food available to them.

5) Health in General - yes, Virginia, there are genetics involved. My paternal grandparents on up the line were good Missouri from the Carolinas from Alsace Lorraine farm stock. Middling sized, dark, long-lived (natural mortality in the 80's - 100's), fairly healthy and active pear-shaped people who, once they put on fat, never seemed to be able to get it off. Even with diet and heavy-duty exercise.
My 5'9 - 11", average 250+ lb grandfathers tended to drink themselves to death - accidents or cirrhosis of the liver type diseases, but my 5'2 - 5", 200lb+ grandmothers were walking without aids (canes or walkers) everywhere, cooking their own meals, farming, and doing pretty heavy duty housework up into their late 90's. In fact, my 5'2" 230lb G-Grandmother was operating her 1905 Singer treadle sewing machine daily making fairly heavy quilts for charity up to the age of 102 (in 1990) when she passed of pneumonia, and it's still hard for me to imagine how she was able to handle backbreaking-ly hard work it is pushing and pulling a 6' x 5' rectangle of 1" batting and 4 to 6 layers of cloth accurately through a treadle sewing machine...at the age of 101. I'm not as lucky as she was, I've been injured badly throughout my life, and probably won't last that long, but - looking at pictures of G-Grandma at 101, she looked like a typical obese 70-year old grandmother - not frail at all.

and finally -

6) Perception - People who are good at sports have a hard time understanding why everyone isn't good at sports, just as people who are good at the arts - who are curious, actively seek inspiration and create ways entertain themselves - can't conceptualize those who are happy to have their lives set out for them and enjoy passive entertainment. So, it's easy to castigate fat people as "weak with no control", instead of being someone different from "us" living in different circumstances that have to be dealt with. You're only fat because you're lazy, and there are no other root causes that could contribute to your situation because you simply aren't trying hard enough. It's easy for me to be slim and athletic, why isn't it as easy for you?

Shaming the fat for their condition is similar to shaming the poor for theirs. It's easy to overlook factors such as Luck, Opportunity, Genetics, Mental Awareness and Capabilities.
As some people are in financial problems because, while they might be good craftspeople and hard workers, but they can't wrap their minds around figures and have no concept of money, some people can't get their minds past their bodies screaming "I'm starving, stressed out, and I'M GOING TO DIE!" while others have no problems turning off that part of the lizard brain.

13. Like you, I am baffled by the lack of longer inseams in the smaller sizes ...

... of men's pants.

That, and, there are some problems that need to be addressed as a society. We have structured our cities and towns so that exercise is not something that just happens naturally as part of everybody's daily routine. Most people can barely cook, and have as much misinformation about nutrition as actual information. We have allowed manufacturers to mislead people about what is in their food, and to include harmful ingredients.

Blaming individuals will not solve these problems. It's mean, and it's counterproductive.

27. In one way it certainly makes sense that we create labor-saving devices.

How many people want to go back, after all, to washing their laundry on a rock by a stream, or with a washboard?

Since we're often in a hurry, it's hard to blame people for not wanting to take the time it takes to walk to many places they have to go.

After saving all of that time and energy, however, we still need the raw activity itself. We end up walking and running in circles just for the sake of motion. We lift weights that aren't stones to build fences or boxes of goods to put on store shelves, they're just weights for weight's sake that go right back to where we picked them up from in the first place.

If we can find replacement activities for all of the missing activity that's fun and enjoyable, it would be a plus -- technology saving us drudgery and giving us more time for pleasure. I doesn't seem to work out that way for many people. I wish I enjoyed my own workouts I do more than I do -- sometimes I get a little pleasure out of exercise, but it's mostly just a chore to get through for me.

28. Exercise needs to be more than fun and enjoyable...

... and it needs to be useful for more than fitness. If people are too busy, they will forgo exercise even if they like it and know it's good for them. If they have to exercise in order to get home from work, or light their house, or shop for food, they will.

This is not an individual failing, it's the very structure of our towns and our livelihoods. Yes, it can be overcome by people with time and willpower, but, as long as it requires that, a large portion of the population will be sedentary, and they will be suffering ill effects from being sedentary.

41. How would you implement the increased exercise?

Ban and/or prohibitively tax certain labor saving devices? Legally require longer distances between bus stops and subway stations? Restrict elevator usage to the handicapped and legally require everyone else to use the stairs? Get rid of shopping carts so people have to walk to the grocery store more often, and do more weight bearing exercise by lugging their shopping bags?

I don't really think you're proposing anything so intrusive or meddlesome, I'm only saying that while I get that you'd want to try to make exercise a more necessary and organic part of people's daily lives, I don't get how you'd make that happen.

42. A large percentage of our population lives in areas ...

... where walking is not possible. We need sidewalks and streetlamps; we need bike paths that go somewhere; we need zoning that doesn't put housing many miles away from schools and shopping; we need reliable and efficient public transportation so that people have an option other than driving. Americans are no lazier than any other people, but we're considerably more likely to drive for every single chore, and because of that over 30 percent of us are obese.
People don't need to be coerced to walk, but it needs to be as convenient as driving.
None of this is intrusive, and people who live in walkable communities are not just healthier, but happier.

We also need to teach nutrition to all our children in a way that is not dictated by the people who market food products to them. We need to make sure nutritious food is available in every community, and set some nutritional standards for food products that claim to be "meals".

14. Sugary sodas have a LOT of calories. Second, you are male. 3rd, you weren't morbidly obese.

I think that morbid obesity is a different problem from being overweight or even slightly obese (which isn't as fat as people think).

There is a genetic component to morbid obesity. There has been a "fat gene" identified, even. This may not mean someone is destined to be morbidly obese, but makes it likely.

You are male. Women, who have a higher fat composition to begin with, are prone to gain more weight more easily. There is a misconception that "plump" women are eating doughnuts and fast food, when a plump woman may simply be eating a couple hundred extra calories per day, which adds up to 15 pounds in a few years. It is also harder for women to lose weight, since they can't eat that many calories to begin with. If you eat too few calories, your metabolism slows down, requiring you to eat even less.

A woman living an ordinary life, who weighs 140 pounds, will take in 1400 calories or thereabouts to maintain that weight. To lose weight, say 40 pounds, (3500 cals = 1 #, so she'd have to eat 40 X 3500 fewer calories = 140,000 calories). If she eats, say 1200 calories a day, it would take her 700 days to lose 40 lbs, or about 2 years. Whereas a man can drop 40 pounds fairly easily, esp if he pumps up his muscle, which is easier for him to do than a woman.

I am normal weight, but I have struggled with an extra 20 pounds in my past. I lost it, but it took a loooong time, and I ate about 800 calories a day. I grew up in a family with morbidly obese people, so I've seen that issue up close and personal. That is a different problem than regular weight struggles.

But you're right in that I've noticed some personality traits in morbidly obese people that those w/o that issue in the family did not have. They're not good traits, but we are all cursed with our traits. They also seem to have a compulsive eating issue....they just can't stop. These are deep issues, not cured with calorie curtailment or exercise.

In the end, though, it's what you eat that counts most. If you eat little, and eat mainly vegetables and fruit with some lean fish and poultry, you probably won't be overweight, and you certainly will be healthier. Stay away from fast food. I believe that it is IMPOSSIBLE to maintain a normal weight AND be healthy if you eat at fast food places regularly (regularly being more than once or twice a month...and even that is dangerous).

I've noticed, too, that overweight people view food as a social event. They LOVE to go out to eat, and remark on their food and other people's food (whereas I rarely do, and I don't even notice what other people are eating). I do not like to go out to eat. It's boring. To me, eating is something you do in between doing other things...something to do and be done with and move on. As a person who has struggled with weight, I enjoy food, but not as much as others seem to. I eat healthy, which isn't much fun. I enjoy my lunch, but I don't revel in it, I'd say. It's pretty good, it's okay, but not a major joy in my life. But I'd rather that than have diabetes or be 30 pounds fatter or have high blood pressure or high cholesterol.

20. I actually eat out A LOT, which might surprise some people.

Neither my wife nor I are very much into cooking -- which would make healthy eating simpler in a lot of ways -- so I just have to be careful about my restaurant selections. Breakfast is about the only meal I normally have at home. While I've just started making myself eggs for breakfast now and then to get a bit more protein for muscle building, my typical breakfast is greek yogurt, a protein/nut bar, and maybe a banana.

One thing that helps is going to restaurants that don't mind special orders. I substitute whole grain pasta for regular pasta when I can. I have salad dressings on the side so I can apply it sparingly. I ask them to go light on sauces.

It really helps that I have a great salad bar at the cafeteria at work so I can make my own custom salads with a good variety of fresh vegetables, including things like chickpeas and black beans to go beyond just the green, leafy vegetables. Instead of using low-cal or no-cal dressings I use a sparing amount of blue cheese, under 100 calories worth.

It helps that, even when I was heavier and not so conscientious about my diet, I never understood why so many of my fellow Americans were enamored with smothering salads with thick globs of dressing, slathering sandwiches with oozing quantities of mayonnaise, and drowning pasta in puddles of sauces.

When I had a hard time getting a dish at Friday's called Cajun Shrimp and Chicken Pasta to come out to my taste and dietary requirements, because simply saying "go light on the sauce" produced very variable results, I eventually discovered that what I had to say was "one quarter the usual sauce" to get the meal to come out right. I'm baffled that most people either like, or at least tolerate, four times the amount of fattening sauce than I find completely sufficient. (I also have Friday's substitute their multigrain angel hair pasta for the standard fettucini, and I ask for extra red bell pepper.)

My "fast food" these days is mostly Panera and Chipotle, 2-3 times per week. I give into a burger at Five Guys or Burger King maybe once or twice a month.

37. I'm with you on the sauces and dressing.

I've never been a big lover of sauces, and I've always used dressing sparingly. I want dressing drizzled on a salad, not some salad to go with my bowl of dressing! I'm cajun, so I grew up with sauces, but I never cared for them much. I prefer the natural taste of the main food I'm eating.

I haven't cared much for mayo since I was a child and there was a rash of silly jokes comparing mayo to snot. I lost my taste for mayo during those days... luckily, as it turns out.

I save my calories for things I really love, like fried chicken. I just love it. I have it about 6 times a year, I guess? Maybe more. That's one of my indulgences.

You eat out I guess because you like to eat. I wouldn't say that I like to eat the meals I eat. They're ordinary, usu. I love some things I eat, but usually it's a natural food that isn't found in a restaurant. I had mangos for dinner tonight. Nothing else. Fresh, sweet mangos. I can't go to a restaurant and get several raw mangos, and even if I could, it'd cost a fortune. I got these on sale for 44 cents each. But I had a baaaad huge taco salad for lunch (hence the light dinner).

It's a struggle, but I do feel better when I eat closer to the ground (fruits & plants and no sugar or much fat), and eat lightly. Now, if I could give up sugar, I'd be set. That's another weakness of mine, but that's another story.

32. You can control your weight in the same sense that gay people can control their sexuality

If you are inclined to be fat, you can choose spend all your time and effort fighting it in order to appear as normal as possible, or you can choose to have a life. If you are gay, you can choose to marry heterosexually and ignore your inclinations. Quite a few conservative gays actually succeed in doing it, too.

56. It is possible to control your sexuality in exactly the same way

If you are gay, just never act on your inclinations. This is somthing that a minority of gay people actually succeed in doing. And whether or not anorexia results in extreme thinness depends on genetic factors.

Anyone can decide on developing better health habits. What no one can ever do is control the results of doing that. Your mileage not only may vary, it must vary.

18. Your story is very similar to mine, though I've never been obese.

I have gotten back on a fitness kick since the New Year's, and have lost about 20% of my body weight - basically all fat. Through changing eating habits and moderately vigorous exercise every other day.

Exercise IS vital for me, as you say it is for you, since it helps suppress my appetite. I come back from a workout and I'm really not hungry. And anyway, my current diet doesn't leave me hungry at all, ever. I can even snack - on nuts and healthy things, of course.

21. I certainly knew I'd been overweight, but it took a while for me to think of myself as "obese".

It's both a blessing and a curse that I tend to distribute extra fat fairly evenly around my body instead of, say, mostly packing it on my gut. When I told some friends that I was setting an initial goal of losing 80 lbs, many didn't think I had that much to lose. Despite that general impression, however, on the BMI scale (which admittedly has to be taken with a big grain of salt) I'd actually managed to reach the threshold of "severely obese".

Now that I'm 178 lbs and slender, but by no means skeletal or scrawny, it seems completely reasonable that piling on 85 extra pounds of mostly fat to my current body should easily be considered very obese.

29. "free gym at the office" Can you say class privilege? I knew you could.

That is basically what fat bashing is all about. 100 years ago, being pale and fat made the social statement " I sit around in the shade all day and drink mint juleps, unlike you lower class slobs chopping cotton in the hot sun." Today, being tan and thin says "I play tennis in the summer and ski in the winter and can afford a personal trainer, unlike you lower class slobs sitting and standing around indoors in factories and offices."

Also, you might consider getting over the snotty delusion that eating healthier and exercising more will make fat people into thin people. What it does mostly is change us into fat people who weight somewhat less and are healthier.

46. I lost most of my weight before I even got near the gym at work...

...with walking in a public park and my own elliptical rider at home as my chief forms of exercise. "Class privilege" will now make it a bit more convenient to keep going with my exercise, but it's hardly a necessary component of what I'm doing for myself. Previously in my life, through most of the 90s when I kept off my excess weight, I never had a free gym at work, just an exercise bike at home and a very cheap membership in the kind of local gym that plenty of people have access to.

I've already admitted that I'm fortunate to have the time to be able to fit exercise into my daily schedule, admitted that the addition of a long daily commute broke me of my own good habits once before, so I think I've pretty clearly expressed sympathy and understanding for the fact that not everyone can easily manage to find the time for exercise.

If you're trying to cast this as an issue of misogyny, then damn, there's a whole lot of misogyny inflicted on women by women, who often obsess over their own and each other's weight much more than men do. (No doubt that's been imposed on them by men somehow.)

As for any "snotty delusion", at this point it's clear you're just railing against your own pre-existing enemies list, and dealing with your own big chip on your shoulder, more than anything that I've specifically said.

53. The biggest class/income issue when it comes to exercise might be available time...

...and even that's not a clear cut advantage for upper-income people, since many get the big bucks by putting in long hours at the office and/or on the road. You have to be pretty well-off before you can start paying other people to take much of the time-consuming stuff off your hands. Then again, whatever long hours some wealthier Americans put in, it might not be as much as some poorer Americans working multiple part-time jobs trying to make ends meet.

The food part of this equation, however... class and income probably make a bigger difference, since some of the cheapest calories are some of the most unhealthy, and food choices tend to be more limited in poorer neighborhoods. Perhaps there's a cultural divide too, with not as much disdain for fast food among people with lower incomes, and maybe a perception that some healthier choices are a bit "snooty".

I fully admit the above is mostly guesswork and half-remember info off the top of my head. If someone has solid info regarding income, class, food, and exercise, I'll gladly become better informed, and corrected if necessary.

57. Do you think so?

33. I get what you are saying but there are some things that need to change in our country

to help get the obesity levels under control that are beyond the average individuals control. For example take your local McDonalds someone swings by there because they don't have much time to cook dinner or get lunch or they're on a road trip and its the only option. The Double cheeseburger is $1 while the salad is $6 most are gonna go for the cheaper option. Same in the grocery stores for those on a very limited budget the unhealthy crap most of the time is in their price range while the stuff that'd better for you is twice the price. We have to find a way to make the healthier options affordable. My second point starting in elementary school or middle school/junior high nutrition classes should be part of the curriculum. When I went to culinary school we were required to take one as part of our classes and it really does enlighten you to things even things you think are healthy can be just as bad for you.

35. You may or may not lose weight if you eat less and exercise more

It is true that the First Law of Thermodynamics must apply to the human body. And, given the simplistic approach which most people take, they are confused about what 'consumed' and 'burn off' mean.

Mitochondrial ATP uncoupling for heat generation has been indentified as one of the major energy utilization systems of the body and could account for 20-50 lbs/year of weight gain for people whose basal temperature is less than normal.
.
There are active control systems which reduce the amount of energy used involuntarily for many of the body's autonomic functions. There are also significant energy excretion systems which are active also. According to the laws of thermodynamics it must be the case that --

It should be noted that there is manual "free will" control only on C and V. People who think of human metabolism as a bank account are willfully ignorant that these other variables adjust automatically within an active control system. All adjust when any one of them changes. When C and V are changed "manually", there may be permanent alteration to the control system (as in long-term dieting).

The amount of energy stored is not 'whatever is left over'. The body actively stores or mobilizes energy from its energy store. If there is a energy deficit resulting from eating less and/or exercising more, it tries to increase C, causes a reduction in I, H, and E, and even actively prevents V. If there is an energy surplus, it tries to decrease C, increases I and H, encourages V, and, as a last resort, increases E.

The control system for these actions is decentralized. So it is possible for the energy store to believe that it needs to increase S, while simultaneously, the liver believes that it is necessary to increase E. This leaves I, H, and V at an extreme disadvantage.

If a fat individual is not lethargic and ravenous, then the control system is not unbalanced, but has a different equilibrium than average. One may wish that the equilibrium were different, but the system is not amenable to manual control (especially by manually varying C), and there are strict limits to an individual's ability to change it.

Decreasing C (dieting) has been shown to cause a long-term decrease in H and a long term increase in S, and to prevent I from increasing when V is increased. Millions of dieters have experienced this. Obesity researchers have verified this. And your typical snotty fat-basher will forever refuse to understand this.

38. Nice breakdown of all the caloric "ins" and "outs"

The big question is that if you both decrease C and increase V, just how far can the human body go in order to maintain or increase S in the face of decreased C and increased V?

How far can and will your body temperature (H) drop just to keep maintaining body fat? Just how much will muscle maintenance and involuntary motion (I) be abandoned in order to prioritized body fat?

No doubt all these caloric complications interact with individual characteristics to make weight loss harder for some people and (disgustingly!) easier for others. (My own body temperature is more typically ~96°F instead of the supposedly normal 98.6°F, so that might make weight loss harder for me.)

I suspect that the number of people whose bodies would prioritize fat storage to the point of obesity while greatly dropping body temperature and/or cannibalizing muscle tissue are fairly rare. When whole populations start getting fatter across the board, it's got to be mostly about diet and exercise for the majority who are affected, since the basic underlying biology of the population can't suddenly change over a few decades.

43. The answer to how far the body can go is "A lot".

If you ever doubt it, take a heavy lifting job working 7/12-16s for a month or so and don't eat properly. I did it when I was young and stupid. (Now I'm older and still stupid. ) After the first two weeks you're barely able to think straight. Your muscles get weak, your hand-eye coordination goes out the window, your body temperature not only drops on average(Mine fell 2.9 degrees below normal at one point), but won't regulate itself for excess heat properly either, your heartbeat becomes irregular, vision becomes blurry, ears ring, your senses become completely unreliable, you bruise more easily, soreness and injury won't heal, etc. I've gotten those symptoms and I'm not out of shape at all. My friend that's in positively phenomenal shape got the same symptoms. If I had to guess I'd say I was consuming 1600-1800 a day, he was consuming 2000-2200 a day, so we were a long way from starving. We were just burning way more than we consumed. I've seen overweight people go through the same issues on jobs like that when they didn't eat enough.

Basically your body realizes (Or at least thinks) you're dying and does everything it can to try to stop it, which means shutting down as many non-essential systems as possible as early as possible to prolong having to shut down essential ones. Eventually (And we didn't come close to this point) it'll start shutting down essential systems. The problem is what your body considers "non-essential" is frequently stuff we'd really like to keep going.

I wouldn't think people whose bodies would cannibalize muscle for fat would be rare. There's not a population on this planet that's more than ten generations removed from a constant threat of famine. In a famine the people who could keep away from the point of no return the longest were the most likely to survive and the most likely to reproduce. (There's a point where not even food will save you anymore.) What changed is access to food and the calorie density of food. Your great great grandparents probably never saw a food where each bite was a hundred calories (e.g. snickers bars), and if they did they couldn't afford enough of it to hurt them. Which is why back then being overweight was correlated with being wealthier. They were the people that could afford to eat.

Being overweight now, on the other hand, is strongly correlated with being poor, primarily because you have to get the most calories for your buck when you can only buy so much food. The most calories for your buck are usually godawful nutritional choices like Ramen noodles, sugars, etc. Things that are only calories with nary a vitamin to be seen.

The only solutions I can see for this are long term ones. Michelle Obama seems to have the right idea: Teach kids to eat healthy and they'll probably eat healthy, or at least healthier as adults.

45. You are forgetting the mitochondrial ATP wastage cycle

That is what would account for most of the difficulty some people have, far more than involuntary motion (which can be almost entirely eliminated). You have to waste really high amounts of ATP to significantly raise body temperature.

Also, there is no evidence that most people are getting fatter, other than by redefinition of obesity. BMI distribution is not a normal curve--it is highly skewed in the direction of higher BMI. The only proper measure of the central tendency of a skewed curve is the mode (most common value), and I have yet to see any research indicating that modal BMI has changed. People most inclined to put on weight in the first place are the ones accounting for the shift in median and mean weights.

It is already an established fact that adult women have stopped getting fatter.

The yearlong study of 62 women ages 24 to 55 encouraged them not to diet but to take part in exercise classes. They were required to do four hours a week of exercise such as tai chi, aqua aerobics or circuit classes. The program also included educational sessions teaching the women how to read food labels as well as behavioral therapy to help the women respond to body cues such as hunger and feeling full. But the women were encouraged to eat whatever they wanted, in moderation.

The women who took part in the study all had a body mass index over 30, which is classed as clinically obese. After a year, the average participant had lost very little weight. But the women were significantly fitter and happier with themselves. Blood pressure, heart rate and cholesterol fell, and respiratory fitness increased. The women also felt better in terms of general well-being, body image, self-perception and stress.

"People of all sizes and shapes can reduce the risk of poor health by adopting a healthier lifestyle," Dr. Erika Borkoles, exercise psychologist at Leeds Metropolitan University told the BBC. "Health care professionals need to shift their focus from weight loss to helping their patients improve their health."

And here's a vigorous male triathlete who is significantly fatter that you ever were.

Exactly. He's one in a million. The existence of rare individuals who can handle a lot of extra body fat in no way proves that extra body fat is a good idea in general for everyone else, or even merely neutral. This case doesn't even prove that extra fat is good for Dave Alexander, just that it's not a big detriment to him. If he's happy with himself that way, all the more power to him.

As for the exercise-but-no-weight-loss study that you cite, what it shows is that exercise is better than no exercise, whether you lose weight or not. Hardly surprising. It doesn't at all say that weight loss is a "totally irrational goal".

(emphasis mine)

Dr. David Haslam, clinical director of the National Obesity Forum, confirmed the study’s findings: "It is quite well known that you can improve your lifestyle and reduce your risk of cancer, stroke and heart disease. You can improve fitness without losing weight, as you can gain muscle and lose fat and weigh the same or even gain weight."

But he disagreed about shifting focus from weight loss to exercise. "It's important to think across the board."

What I get out of the whole of that Alternet article, and other things I've read, is this: Yes, it's quite natural for some people to weigh more, even quite a bit more than others. But the extra weight can only be healthy up to a point, no matter how hard it might be for some people to fight it.

The human body has evolved to deal with scarce food supplies and the need for a lot of physical effort to track down what little food was normally available. Being surrounded by plentiful food and not needing to expend great physical effort to obtain it is a very unnatural set of circumstances. Most of the weight gain that such circumstances lead to is not going to reflect a healthy bodily response finally being realized by the bounty of modern living, but a maladaptive response of survival traits that are beneficial only in a harsher world.

55. Amended assertion: for women, it is a totally irrational goal

Women very often have histories of extensive dieting, which seriously screws up one's metabolism. Persisting in this pattern is irrational. Middle aged men who have never paid much attention to their weight, and decide that they need to do something about their lifestyle in middle age for the first time, are much likelier to lose weight.

Explain why a middle aged woman with a history of dieting and weight obsession is better off maintaining that obsession rather than just switching to exercising and totally ignoring whether or not that results in weight loss.

Re fat loss vs exercise in getting better blood sugar control if you are diabetic. If you physically remove fat via liposuction with no increase in phyical activity, this has no benefits whatsoever for blood chemistry. Therefore fat accumulation isn't the problem; it's just an indirect marker for low activity levels which are harmful.

Liposuction decreased the volume of subcutaneous abdominal adipose tissue by 44 percent in the subjects with normal glucose tolerance and 28 percent in those with diabetes; those with normal oral glucose tolerance lost 9.1±3.7 kg of fat (18±3 percent decrease in total fat, P=0.002), and those with type 2 diabetes lost 10.5±3.3 kg of fat (19±2 percent decrease in total fat, P<0.001). Liposuction did not significantly alter the insulin sensitivity of muscle, liver, or adipose tissue (assessed by the stimulation of glucose disposal, the suppression of glucose production, and the suppression of lipolysis, respectively); did not significantly alter plasma concentrations of C-reactive protein, interleukin-6, tumor necrosis factor , and adiponectin; and did not significantly affect other risk factors for coronary heart disease (blood pressure and plasma glucose, insulin, and lipid concentrations) in either group.

In conclusion, Alexander's doctor has his head up his ass. If some people are getting significant health improvements from exercise and a healthier diet without much weight loss, is is counterproductive, actively harmful and basically snotty to keep urging them to lose weight.

58. You cited an article as if it backed up your argument against some women even trying to lose...

...weight, but it only backed up one component of that argument, then contradicted your conclusion. I pointed that out.

It's very questionable whether losing fat via liposuction is a fair comparison to losing weight more naturally since the normal process causes very different body changes than simply getting fat sucked directly out of your abdomen (the specific and only form of liposuction referred to in your cited abstract), like changing the fat content of your liver, changing the amount of fat between your bodily organs, metabolic changes, etc. Even so, one newer study, which is, I'll admit, just one study, and about which some doctors are rightly skeptical, hints that liposuction might produce some small heart health benefits.

If you've got enough extra weight that it's causing sleep apnea problems, exercise alone won't fix that because even bulked-up athletes can suffer from sleep apnea due to the weight of extra muscle -- as far as apnea is concerned, weight on your chest is weight, whether it's muscle or fat.

If you've got bad knees, exercise alone can help strengthen your knees, but you're still doing yourself an additional favor if you stop asking your knees to carry around a lot of extra weight.

Is it possible you're onto something about some people just giving up on weight loss? Sure, it's possible, and the less extra weight that we're talking about, the more likely that seems. I certainly don't see myself or many doctors arguing for supermodel standards of thinness. To the extent that some people keep torturing themselves and their bodies with one crazy and unsustainable fad diet after another, it's also certainly possible that no attempt at weight loss can be better than repeated ill-conceived attempts at weight loss.

On the other hand, until there's more definitive proof of your speculative conclusions, even a medical community with a spotty history of weight loss and nutrition wisdom has a better track record than non-professionals speculating on the internet, so for now I'll stick with the notion that (maybe a few rare individuals aside) exercise and a healthier diet and maintaining low body fat is the best health advice for the general population.

59. If low body fat is so healthy, why do fat women outlive men with "ideal" body fat?

Note that in your last sentence, you can do something about exercise and a healthier diet, but you can't do much about body fat--at least if you are female. If fat is such a health problem, men should be outliving women, and the simple removal of fat should lead to significant health benefits.

BTW, limb fat is not associated with poor blood chemistry, but abdominal fat is--check out all the "apple" vs "pear" research results. Removing abdominal fat is therefore removing exactly that kind of fat most associated with poor blood chemistry. This is a clear indication that the health benefits of exercise and good nutrition are in no way mediated by weight loss, but work directly. (Fatty liver is an alcohol-related problem, not an obesity problem.)

I know that you don't really intend to call the women who become healthier without much weight loss just a bunch of worthless pieces of human trash, but regardless of your intention you are doing it anyway.

61. Weight aside, women in the US live an average of five years longer than men

Therefore the ill effects of excess weight could go as far in reducing the life span of women as five years and they'd still, on average, have men beat in the life span department.

You then say, "but you can't do much about body fat--at least if you are female." Who says? Link? And please, not something that says something kinda, sorta related to that idea that you interpret with your own leaps of logic to mean that "you can't do much about body fat", but something that actually, with data to back in up, says that.

"Removing abdominal fat is therefore removing exactly that kind of fat most associated with poor blood chemistry." But body fat doesn't normally reach your abdomen by being injected through a surgical tube. Removing it through a tube, therefore, isn't likely to be completely comparable in biological effect to losing weight naturally, and won't lead to the same concurrent body changes that happen during natural weight loss.

62. Did you read the link about fat women not losing weight with exercise and diet--

--though they improved their health?

http://www.pbs.org/saf/1401/features/diets2.htmThere are hundreds of thousands of papers besides the above documenting the low success rate of permanent weight loss. One quote "Diets don't fail; people do." Of course. The problem is people and their annoying tendency to have lives.

There is no evidence whatsoever that weight loss leads to improved blood chemistry, Sure, there is a correlation, but all the evidence shows that improvements preceed weight loss (and therefore are not caused by it), and that there is zero correlation between improvement and the amount of weight loss. That is, Model B is the correct explanation for the correlation.

64. Why should one equate the frequent failure of diets with the idea that extra weight...

...however much extra that might be, must somehow be healthy and natural? All that shows is we're surrounded by convenient fattening food that's difficult to resist, and that we attempt many ill-conceived, quick-fix diets that either aren't healthy, aren't sustainable, or both.

...it's pretty clear that a more sedentary lifestyle and changes in dietary habits for the worse are causing a lot of health problems, and that extra weight is both a symptom and a problem itself. This is certainly not the case of a large population suddenly being set free to reach their natural, healthy weight.

Different people have different levels of genetic predisposition to weight gain, a difference that is exaggerated in populations like the Pacific islanders. There must be plenty of people among us in the US whose genetic predisposition is similar.

You say, "There is no evidence whatsoever that weight loss leads to improved blood chemistry".

Why do you think the burden of proof is there, and on such a narrow measure of health? There's so much evidence that extra body fat leads to a variety health problems -- especially when we're talking about obesity, not a mere, say, 10-20 lbs overweight, and allowances are made for body composition, build, and gender -- I'd say the burden of proof is on anyone who is pushing the idea that significant extra weight is a healthier condition for anyone except perhaps a few rare genetic oddballs.

Recent news stories that people who weigh more may live longer have to be taken with a huge grain of salt:

65. There is not one shred of evidence that extra fat leads to health problems

--and a great deal that indicates it is a marker for health problems without a direct causative role. (Unless you are maybe taking about people who weigh more than 400 lbs.) Women are fatter than men and live longer. Women are more likely to be obese than men, and still live longer. Type II diabetics who exercise more and limit intake of foods with a high glycemic index improve sugar control and blood pressure immediately, well before any weight loss occurs (which is minimal anyway). If weight loss occurs later, it can't possibly be the cause of health improvement. Further, there is zero correlation between health benefits and the amount of weight lost.

Genetic insulin resistance is one of the most common factors associated with obesity, and obesity is indeed a healthier condition for this population. And we are talking about 30% of Americans here.

If fat (rather than the underlying genetic trait of insulin resistance) is such a problem, why are fat type II diabetics less insulin-dependent, less likely to develop the complications of diabetes, and less likely to die from it than type II diabetics of average weight? {Turkington, R.W. and Weidling, H.K., JAMA Vol 240, p. 833-836 (1987)} Why do diabetic Pima Indian women (the human population with the largest known genetic concentration of insulin resistance) experience the lowest levels of mortality when they weigh twice the actuarial ideal? {Pettitt, D.J., et al Am. J. Epidemiol. Vol 115, p. 359-366 (1982)} (Pima men with the longest life spans weigh 45% more.)

Astrup et al {International Journal of Obesity Vol 11, p 51-66 (1987)} have demonstrated that it is fat people who eat the least who have abnormal insulin response. He compared two groups of fat people, one of which ate less than 1500 calories a day, and the other of which ate more than 3000. Every one of the former group had abnormal insulin response, and none of the latter group. The people who are most at risk genetically for developing type II diabetes are therefore those who are least likely to lose weight, and the most likely to benefit from more exercise and improvements in diet composition, making any emphasis on promoting weight loss as the first and most important consideration particularly perverse, stupid and harmful.

(Sorry for no links--I collected the references 15 years before I got online.)

63. There definitely comes a time when it is slower going.

I use to be able to eat healthy and exercise and lose weight very quickly. This time I'm in my late thirties and it has taken some time for my body chemistry to change but it has begun to accelerate as of late. The first 6 weeks I think I lost 3 lbs. But now after about 11 weeks I have lost 15 lbs. Because I am eating less sugar and saturated fat and more fruits, vegetables, whole grains, lean meats, and good fats, my body is beginning to burn some of its own reserves. But it did take longer for my body to transition this time than previous times. I finally have my sugar cravings under control. Because I am eating lots of nutritous rich food when I do indulge and have a cookie I can quit at one. I don't feel like I have to have another. It's so great.